Pacing of a patient's heart is a useful treatment modality for many different conditions. Some pacing or tissue stimulation treatment methods require or benefit from feedback of clinical information from the patient's heart in order to be properly timed or synchronized. Some of this feedback may be obtained by the sensing of electrical signals from cardiac tissue or the like, however, electrical signals or information often do not accurately indicate the physical state or position of the patient's heart or portions thereof. Strain sensors that measure physical movement of tissue may be useful in many situations to provide information of the physical state or position or movement of cardiac tissue. In particular, piezoelectric strain sensors may be useful for such indications. However, known piezoelectric strain sensors do not necessarily account for the type of cyclic loading and sensitivity needed for cardiac applications. What has been needed are piezoelectric strain sensors that have a high sensitivity and provide a high signal to noise output. What has also been needed are piezoelectric strain sensors that can accommodate the cyclic loading associated with cardiac tissue and other body tissues that undergo significant cyclic loading.